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m n- <br /> °`�" ,-�� ��=_� �"_ a��� Q,rx� ' ria <br /> WHO T <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> 10Submission #•2004- �� 0;1 <br /> Checklist corripleted by (initials) Date, l It <br /> Courier name © STI.San Francisco ©Citant—E -- E,,y—....,.. I f <br /> J Not <br /> Custody seals intact o shaping contwnerf ples Yes No Present_ <br /> Chain of custody present? Yes '' IVa__ _ <br /> Chain of custody signed'when telmquistied and received? Yes � No,^_ <br /> Chain of custody agrees with sample labels? Yes `'� No <br /> Samples in proper eontainerlbottle? Yeas Na <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated tesk? Yes -_ No <br /> All samples received m thin holding time? Yes ✓ No� <br /> --�-, <br /> st�a�terefrl8arxi+ier�r � � �e '�� <br /> � -{ n.^+_ '' '�, m ;a 4 der a�.k - ` r� t�"", �.� " �as �a s "w*'' c �a" g <br /> Am <br /> ����i8s "s'£,�j��+�6eC" �4 a.. x ^• ,moi,$^� � .;• x �+,," rage ca .an .meq '� ao- $` 3 r �"" s 2 ab��a <br /> Mi <br /> ��}A�����^�ii��EL..��t��.a33� lei "�' �� f�� � ��� Mr .€ �+� � er� ,h�a'����� �j�pa�`a` %cz���'➢ r r �p���swl <br /> &: <br /> •Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S(small-0), (medium� 0 <br /> ? Q}�r L(targe�- \.J) � <br /> I <br /> Water-pH acceptable upon receipt? 0 Yes ❑ No � <br /> 3 <br /> 0 pH adjusted-- Preservative used d"NO3©HC 10 I C)a© NaOH ZnOAc--Lot#(a) <br /> For any Item check-listed "No",provided detail of discrepancy in comment section below. <br /> Comments. <br /> I , <br /> Project Management [Routing for Instruction of indicated discrepant f{iesf] <br /> Project Manager (initials) ©ate ! f04 Client contacted I Yes 0 No <br /> E ` <br /> Summary of discussion <br /> Corrective Acton (per pM1ClEent) <br /> E 3 <br /> E <br /> t 33 <br /> 3 <br /> I <br /> i 3 <br />